Agenda item

Briefing report from NHS North East and North Cumbria Integrated Care Board (ICB) and presentation by Sarah Burns, Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria ICB.

The Committee considered a briefing report from NHS North East and North Cumbria Integrated Care Board that provided details on the quality outcomes framework; Investment and Impact fund; helping practices with cash flow and increasing financial flexibilities; Improving patient experience of access (Digital Telephony); registering with a GP and Armed Forces Veterans (for copy of report, see file of minutes).

S Burns, Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria ICB was in attendance to present the report and deliver a presentation that provided details of GP contracts 2024/25; key changes; cutting bureaucracy; cashflow and financial flexibilities; PCN staffing flexibility; support to improve outcomes; improve experience of access; Les/Liaise and how GP services are funded (for copy of presentation, see file of minutes).

Mrs Gott indicated that on the 8 February 2024 they were told that practices had to have specialist mental health practitioners and indicated that this had not been mentioned today. She had asked several professionals how this would work and if each practice would have a mental health practitioner as in her experience if they do not have this, they do not have any insight into the problems people have who have mental health issues.

The Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria ICB responded that they have had specialist mental health staff in practices for a number of years. She continued that through the Additional Roles Reimbursement Scheme the government brought in a mechanism for practices to be funded for mental health staff to work within practice, but County Durham had already done this. In the South of the County these had been in place for seven or eight years and this was expanded and rolled out to the North Durham. This brought mental health expertise into the practice and make services more accessible.

Mrs Gott responded that she was aware some practices did have specialist mental health practitioners but were not replaced when staff retired.

The Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria ICB responded that staff work on a rotation across a group of practices, but all have an aligned mental health worker.

Ms McGee asked if any of the contract changes would have any impact on social prescribing workers and if health checks would be included in the must do’s.

The Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria ICB responded that the contract does not impact on social prescribing link workers as they have a significant number employed across all their practices which remained unaffected by the new contract. In terms of health checks this was a separate contract that was a local authority responsibility. The contact was between Durham County Council, Public Health and Primary Care who work closely together to ensure that they have good take up across the population.

Councillor Earley asked what the feedback from GPs had been to the contract changes and at what point does it come back to the local authority to look at the demands on general practice provision and what was the trigger point to expand a practice.

The Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria ICB indicated that she was unable to speak on behalf of Primary Care but her view was that GP practices were under significant pressure and the demands for appointments was high and they would welcome the reduction in bureaucracy and reduce reporting requirements and would welcome some of the financial flexibilities. When she spoke to GPs their concern was for patients and meeting patients demands which they cannot do that as effectively as they want to. There had been a number of policy initiatives introduced which included having some extended roles within practices, but some people would always want to see a GP. In terms of demands on GP provision there was not a threshold around a practice expansion unless they apply to have their lists closed. Where practices may wish to do this and there were limited situations where this would be agreed. Practices are required to enrol patients in their population, if there was a big housing development in an area they would look to see if they needed additional GP provision and whether S106 monies could be used to secure additional practice capacity should that be were needed and procured.

Councillor Earley indicated that each planning application would have implications for healthcare demand, but any cumulative effect of several housing development applications must be considered by existing provision and whether this needed to be expanded.

The Joint Head of Integrated Strategic Commissioning, County Durham Care Partnership, Durham County Council and North East and North Cumbria ICB responded that she did know if there was a formal criterion but would consult with primary care contract experts and feed this back. She advised members that they have regular dialogue with all their practices who report their pressures on a regular basis. If practices were under regular pressures, they would go out and have a conversation with the practice and work with them.

Resolved: That the information contained in the report and presentation be noted.